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Dr. Thomas Satterwhite

Dr. Thomas Satterwhite, MD is a board-certified Plastic and Craniofacial Surgeon in San Francisco who is dedicated to offering the highest level of surgical care to the transgender community. Dr. Satterwhite works exclusively with trans women, trans men and non-binary patients. His latest research in the field of Gender Surgery is focused on improving the safety and outcomes of Vaginoplasty and surgical and non-surgical techniques for Facial Feminization and Masculinization.

Latest Research

Labial Fat Grafting After Penile Inversion Vaginoplasty.
Patel, V., Morrison, S. D., Gujural, D., & Satterwhite, T. (2021). Aesthetic surgery journal, 41(3), NP55–NP64.
Labial fat grafting is a safe and effective method to address defects in the labia majora after PIV. Prolonged granulation tissue and introital stenosis may predict the need for labial fat grafting, possibly due to increased scarring and contracture at the surgical site.

Estrogen Continuation and Venous Thromboembolism in Penile Inversion Vaginoplasty.
Nolan, I. T., Haley, C., Morrison, S. D., Pannucci, C. J., & Satterwhite, T. (2021). The journal of sexual medicine, 18(1), 193–200.
This study suggests that perioperative estrogen continuation may be safe for patients undergoing PIV, the overwhelming majority of whom are at low baseline VTE risk. However, clinicians should weigh the magnitude of the risks and benefits of estrogen cessation on a case-by-case basis.

Does Portrayal of Skin Tone in Gender-Affirming Literature Represent Diversity?
Abu-Ghname, A., Patel, V., Davis, M. J., Seebacher, N. A., Shen, J. K., Cen, N., Kneib, C. J., Cho, D. Y., Massie, J. P., Vyas, K. S., Streed, C. G., Jr, Morrison, S. D., & Satterwhite, T. (2020). LGBT health, 7(8), 461–463.

Prospective Quality-of-Life Outcomes after Facial Feminization Surgery: An International Multicenter Study.
Morrison, S. D., Capitán-Cañadas, F., Sánchez-García, A., Ludwig, D. C., Massie, J. P., Nolan, I. T., Swanson, M., Rodríguez-Conesa, M., Friedrich, J. B., Cederna, P. S., Bellinga, R. J., Simon, D., Capitán, L., & Satterwhite, T. (2020). Plastic and reconstructive surgery, 145(6), 1499–1509.
No data exist on the prospective outcomes of facial feminization surgery. This study set out to determine the effects of facial feminization surgery on quality-of-life outcomes for gender-diverse patients.

Are We Preparing Patients for Gender-Affirming Surgery? A Thematic Social Media Analysis.
Latack, K. R., Adidharma, W., Moog, D., Satterwhite, T., Hadj-Moussa, M., & Morrison, S. D. (2020). Plastic and reconstructive surgery, 146(4), 519e–521e.

Social Perception of Facial Feminization Surgery Outcomes: Does Gender Identity Alter Gaze?
Martin, S. A., Morrison, S. D., Patel, V., Capitán-Cañadas, F., Sánchez-García, A., Rodríguez-Conesa, M., Bellinga, R. J., Simon, D., Capitán, L., Satterwhite, T., & Nazerali, R. (2020). Aesthetic surgery journal, sjaa377. Advance online publication.
The evaluation of gender-affirming facial feminization surgery (FFS) outcomes can be highly subjective, which has resulted in a limited understanding of the social perception of favorable gender and aesthetic facial appearance following these procedures. The growing use of eye-tracking technology in the assessment of surgical outcomes has introduced an objective measure of viewer subconscious gaze, which may provide more insight into how viewer characteristics may influence gaze, attention and perception of favorable FFS outcomes.

Staying on Top of Breast Implant Illness: An Analysis of Chest Feminization Experiences.
Latack, K., Adidharma, W., Nolan, I. T., Crowe, C. S., Sowder, L. L., Satterwhite, T., & Morrison, S. D. (2020). Plastic and reconstructive surgery, 145(4), 885e–886e.

Outcomes and Predictors of Revision Labiaplasty and Clitoroplasty after Gender-Affirming Genital Surgery.
Boas, S. R., Ascha, M., Morrison, S. D., Massie, J. P., Nolan, I. T., Shen, J. K., Vyas, K. S., & Satterwhite, T. (2019). Plastic and reconstructive surgery, 144(6), 1451–1461.
This study describes complications and outcomes from the largest reported cohort in the United States to undergo penile inversion vaginoplasty with subsequent revision labiaplasty and/or clitoroplasty.

Nonsurgical Management of Facial Masculinization and Feminization.
Ascha, M., Swanson, M. A., Massie, J. P., Evans, M. W., Chambers, C., Ginsberg, B. A., Gatherwright, J., Satterwhite, T., Morrison, S. D., & Gougoutas, A. J. (2019). Aesthetic surgery journal, 39(5), NP123–NP137.
Facial feminization can be achieved through injectables such as neurotoxin and fillers for lateral brow elevation, lip augmentation, malar augmentation, and improvement of rhytids. Facial masculinization can be achieved with injectables used for genioplasty, jawline augmentation, and supraorbital ridge augmentation. One must develop best practices for these techniques in the transgender patient population and increase awareness regarding nonsurgical options.

Breast augmentation in male-to-female transgender patients: Technical considerations and outcomes.
Miller, T. J., Wilson, S. C., Massie, J. P., Morrison, S. D., & Satterwhite, T. (2019). JPRAS open, 21, 63–74.
There is minimal literature describing effective and safe techniques for breast augmentation in transwomen. Here we describe our operative techniques and considerations.

Lower Jaw Recontouring in Facial Gender-Affirming Surgery.
Morrison, S. D., & Satterwhite, T. (2019). Facial plastic surgery clinics of North America, 27(2), 233–242.
Lower jaw contouring can be used to harmonize the face during facial gender-affirming surgery through masculinization or feminization. During feminization, the mandibular angle and body and chin are reduced in width and size. During masculinization, augmentation of the mandibular angle and body and chin are completed with alloplastic implants, fat, or bone. Complications are minimal. Further research is needed on outcomes of these procedures.

International phase I study protocol to develop a patient-reported outcome measure for adolescents and adults receiving gender-affirming treatments (the GENDER-Q). FREE TEXT
Klassen AF, Kaur M, Johnson N, Kreukels BP, McEvenue G, Morrison SD, Mullender MG, Poulsen L, Ozer M, Rowe W, Satterwhite T, Savard K, Semple J, Sørensen JA, van de Grift TC, van der Meij-Ross M, Young-Afat D, Pusic AL. BMJ Open. 2018 Oct 21;8(10):e025435.
A critical barrier to outcome assessment in gender-affirming healthcare is the lack of a specific patient-reported outcome measure (PROM). This phase I protocol describes an international collaboration between investigators in Canada, Denmark, the Netherlands and the USA who have coalesced to develop a new PROM (ie, the GENDER-Q) to evaluate outcomes of psychological, hormonal and surgical gender-affirming treatments.

Feminization and Masculinization of the Neck
Salgado CJ, Nugent AG, Satterwhite T, Carruthers K, Joumblat NR. Clinics in Plastic Surgery.
Volume 45, ISSUE 4, P635-645, October 01, 2018.
Facial stigmata associated with one’s assigned gender can be very distressing for the gender dysphoric patient. The lower face and neck contain several structures that play a significant role in their ability to “pass” as their desired gender. Clinical recognition and modification of these structures will allow the patient to have facial and neck features that are consistent with their desired gender. This article reviews the techniques of mandibular angle contouring, genioplasty, chondrolaryngoplasty, facelift, and neck lift as they pertain to the feminization and masculinization of the face and neck of the patient with gender dysphoria.

Predictors of Patient Satisfaction and Postoperative Complications in Penile Inversion Vaginoplasty.
Massie, J. P., Morrison, S. D., Van Maasdam, J., & Satterwhite, T. (2018). Plastic and reconstructive surgery, 141(6), 911e–921e.
This is the largest study of penile inversion vaginoplasty in the United States to report on both postoperative complications and patient-reported outcomes. Despite moderate complication risk, patient satisfaction remains very high after penile inversion vaginoplasty, with the majority of patients reporting improvement of their gender dysphoria.

Patient-Reported Outcomes in Gender Confirming Surgery.
Massie, J. P., Morrison, S. D., Smith, J. R., Wilson, S. C., & Satterwhite, T. (2017). Plastic and reconstructive surgery, 140(1), 236e–237e.

Facial Feminization: Systematic Review of the Literature.
Morrison SD, Vyas KS, Motakef S, et al. Plast Reconstr Surg. 2016;137(6):1759-1770.
Facial feminization surgery appears to be safe and satisfactory for patients. Further studies are required to better compare different techniques to more robustly establish best practices. Prospective studies and patient-reported outcomes are needed to establish quality-of-life outcomes for patients. However, based on these studies, it appears that facial feminization surgery is highly efficacious and beneficial to patients.

Long-Term Outcomes of Rectosigmoid Neocolporrhaphy in Male-to-Female Gender Reassignment Surgery.
Morrison, S. D., Satterwhite, T., Grant, D. W., Kirby, J., Laub, D. R., Sr, & VanMaasdam, J. (2015). Plastic and reconstructive surgery, 136(2), 386–394.
This study is one of the largest and longest reported series of rectosigmoid transfers for vaginoplasty in transsexual patients. Rectosigmoid neocolporrhaphies have many times been recommended for secondary or revision surgery when other techniques, such as penile inversion, have failed. However, the authors believe the rectosigmoid transfer is safe and efficacious, and it should be offered to male-to-female patients for primary vaginoplasty.

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